Timeline of Crackdown on Free State Activists & Healthworkers

This is a timeline of events over the last 24 hours of the Free State civil disobedience by activists and healthcare workers. This will be udpated here as new developments unfold. You can also follow our twitter feed for live updates @TAC #FSHealthCrisis

27 June 2014

Community health workers gather at Bophelo House in Bloemfontein, the headquarters of the Free State Department of Health. Their contracts had not been renewed and they had not been offered an explanation. A meeting with a health official leads to an agreement that a meeting with Health MEC Benny Malakoane will take place within seven days.

The Treatment Action Campaign (TAC) releases the results of a fact -finding mission across the province. It is established that there is a health care moratorium in the province with massive stock-outs, shortages and system collapse. There is a call for the Health MEC to be fired. In addition the TAC make the following demands:

– Premier Ace Mashagule must remove Benny Malakoane from his position as MEC of Health in the Free State. If Mashagule is not willing to do this, we call on the ANC’s national leadership to intervene.

– Recently dismissed community healthcare workers must be reinstated with immediate effect.

– A turn-around plan for the provincial health system must be developed as a matter of urgency. It is essential that this turn-around plan be led by committed and qualified people – and not the current MEC.

– The secretariat of the Provincial AIDS Council must be moved out of the Department of Health so as to ensure independence and more effective civil society engagement.

– The Free State Department of Health must come clean about its financial problems. The public has a right to know how the Department is spending money – especially in the midst of a crisis like the current one.

Over 100 Community Health Workers (CHWs) and TAC activists from across the province start a peaceful vigil outside Bophelo House in an effort to draw attention to their plight. The TAC announces the commencement of a civil disobedience campaign.

Further police back-up arrive on the scene and protestors are ordered to disperse or face arrest.

01h00

Police tell protestors they have been sent by the Health MEC Benny Malakoane.

01h30

Police move in and start arresting male CHWs and male TAC activists, including TAC leader Macobane Morake who is punched in the face by one of the policemen (TAC has a photograph of the policeman who was not wearing a name tag).

02h00

Arrested protestors are taken to Park Road police station

03h20

Police send back-up transport to take arrested protestors to police stations including Mangaung police station. Women, many elderly are now also arrested and taken to police stations.

Police hold protestors with no update on whether they are being charged.

05h40

Protesters are told they are being charged for taking part in an illegal gathering.

06h00

TAC in the Free State mobilise members to picket outside the police stations until CHWs and activists are released.

Matshidiso Monaheng appointed as CHW spokesperson 0717318367.

09h00

Legal support organised and travel to Bloemfontein to negotiate the release of CHWs and activists.

12h00

An attorney in Bloemfontein gets confirmation from the investigating officer that the group will be brought in front of the Magistrate tomorrow morning. At this court appearance they will be formally charged. They will apply for bail at this stage.

13h15

Another 50 TAC members are arrested for picketing outside Bophelo House and taken to Park Road police station. They are forced inside police vans.

13h25

The TAC phone ANC General Secretary Gwede Mantashe. He indicated that he does not see it as his responsibility to deal with ANC leadership in the Free State.

The challenges facing community health workers (CHWs) include, but are not limited to, uncertain and irregular employment status.

CHWs are paid inadequate and meagre salaries, exposed to general poor working conditions, restricted access to particulars of employments, unregulated working hours and other violations of the Constitution, including relevant labour and other laws.

A substantial number of complaints have been received by the TAC from CHWs in various parts of the country, particularly Gauteng, Eastern Cape, North-West and Mpumalanga.

CHWs are contracted directly by the Department of Health (DoH) in the Eastern Cape whereas in Gauteng and other provinces they are largely employed through Non Profit Organisations (NPOs), with the role of government being limited to the provision of the necessary funding to the relevant NPOs to sustain the project.

In this regard NPOs concluded service provider agreements with the Gauteng DoH. The funding is supposed to be provided on a quarterly basis but, in practice, this is done in a haphazard and irregular manner.

As a result CHWs often remain unpaid for months during what is generally referred to as “dry seasons,” which impacts negatively on health service delivery. There is therefore an urgent need to standardise the CHW programme to allow for its effective management and monitoring.

The umbrella term “Community Health Worker” (CHW) embraces a variety of community health aides trained and working in the communities from which they originate. These include home-based carers; lay counsellors; care-givers; outreach carers working in South Africa’s health and social systems. These are further divided into facility based voluntary counseling and HIV testing (VCT) and adherence counselors, TB/Directly Observed Treatment Supporters (“DOTS”) and HIV home based carers or more generalist CHWs.

CHWs continue to be directly incorporated into various governmental plans, which among others include the National Strategic Plan on HIV, STIs and TB, 2012-2016 (“NSP”), the Tuberculosis Strategic Plan for South Africa, 2007-2011 (“TBSP”) and the HR Framework.

The circumstances under which CHWs are expected to perform leave them vulnerable to poor working conditions, including illness, crime, financial instability, and uncertainty regarding their supportive role within the health care system.

CURRENT SITUATION

– The Department of Health (DoH) has emphasized that out of the estimated 70 000 CHWs, only 40 000 will be formally employed as part of the Ward Based Outreach Teams included in the new policy.

– There are no clear timeframes as to when the DoH will eventually absorb the CHWs – as of November 2013 only 9 000 CHWs had completed phase 1 of training.

– Many CHWs are currently unemployed with no communication on what their fates are.

– The DoH is developing a policy that deals with the CHW challenges. A draft policy has been circulating since last year.